Privacy is a basic right for all residents. Privacy can be physical, as when closing the curtain each time when giving care. It can also protect resident information and medical history.
It is important for every health care professional to only perform tasks that are within the scope of practice. As a CNA, you are a valuable team member to contribute to a care plan conference. The other tasks are for the nurse.
Elastic stockings, or anti-embolism stockings, are used for patients who have had surgery or are unable to ambulate. Make sure the size is correct for the patient before starting. Assist the patient to lie down in a supine position. The patient’s feet and legs should be dry. Roll the stocking inside out all the way to the heel. Fit it on the foot and heel, then roll it up onto the patient’s leg. Smooth any wrinkles and make sure the stockings are straight. Talcum powder can be helpful to prevent friction and rubbing on the skin.
Hearing aids are expensive devices and care must be taken to avoid getting them wet. If a hearing aid does accidentally get wet, turn it off and remove the battery. Dispose of the battery. Open the battery door and allow the battery to completely dry out, which can take a day or two. Insert a new battery before using it again.
Every client should be encouraged to be as independent and active as possible. Participating in their own ADL is important. Even clients who must remain in bed can often still participate in their care. They can move and turn in bed during the linen change. They can assist with their bed bath and perform their own oral care. The nurse aide should encourage the client to do as much as possible.
Back rubs can promote relaxation, while giving you a chance to observe the resident’s skin. Although you will warm the lotion in your hands, the resident may feel chilled during the back rub. Cover the resident with a bath blanket for warmth and privacy. Expose the area being massaged, then return the blanket when finished.
The CNA is not allowed to give any medications, but can use other ways to help a patient with pain relief. Non-medication methods have been shown to be effective ways to deal with pain. Distraction by listening to music or watching television can be effective. Breathing and relaxation techniques can be similar to meditation. Guided imagery is useful for visualizing pleasant and positive scenarios.
When a device, such as a hearing aid, does not seem to be working, begin by checking to see if it is turned on, if the volume is correct, and if the battery is inserted properly. Often the solution is something simple that the patient has overlooked. If it still doesn’t work, try a new battery. Finally, tell the nurse.
Compression stockings or anti-embolism hose help prevent blood clots and swelling. Make sure the size is correct for the patient before starting. Assist the patient to lie down in a supine position. The patient’s feet and legs should be dry. Roll the stocking inside out all the way to the heel. Fit it on the foot and heel, then roll it up onto the patient’s leg. Smooth any wrinkles and make sure the stockings are straight. Talcum powder can be helpful to prevent friction and rubbing on the skin.
Always start by telling the resident what you are going to do. Raise the bed to a comfortable height. After removing the top blanket and sheet, cover the resident for warmth and privacy. Roll them to their side, with the opposite side rail up. Roll the dirty bottom linens tightly toward the patient, tucking them under the resident’s shoulders, back, and feet. If the mattress is soiled, clean and dry. Place the clean linens on the bed, rolling to meet the dirty linens. Tell the resident they will be going over a bump and help them roll to the clean side, with the side rail up. Move to the other side of the bed to remove the dirty linens, clean and dry any soiled areas. and pull the clean linens into place, making sure they are smooth. tuck in all corners and place the clean top sheet and blanket.
When transferring a patient to a wheelchair, the wheelchair must be locked before starting. The foot plates should be out of the way, and the floor should be free from obstacles. Position the wheelchair directly next to the bed (or toilet, chair, bench, etc.). An angle of 30-45 degrees is helpful. The patient should have non-slip footwear for the transfer.
Keeping dentures clean is an important part of patient care. Always handle dentures carefully, because they are expensive. Before cleaning, place a paper towel or washcloth in the sink to provide a cushion in case the dentures fall. Hold the dentures over the sink and brush them with toothpaste or a denture cleaner, using a soft toothbrush. Rinse under running water.
A sitz bath cleans and soothes the perineum, promotes healing, and reduces pain. It is often recommended after rectal surgery or vaginal births. The water is about 100 degrees, at a level of about the navel. The sitz bath lasts about 15-20 minutes.
When giving a bed bath, the perineum is the last area to be washed. After bathing the patient’s body, empty the basin and refill with warm water. Place a towel under the patient’s hips and buttocks. For females, wash front to back, from labia to perineum. For males, wash the penis and scrotum. For both genders, turn the patient on their side to wash the buttocks and anal area. Dry the area well.
Parkinson’s disease is a chronic movement disorder that gets worse over time. Patients develop tremors in the hands, arms, legs, and face. They walk slowly with a shuffling gait. About 70% of patients fall because of balance problems, so assisting them when walking may be necessary.
Following a stroke, paralysis occurs on the side of the body opposite the side of the brain where the stroke happened. 9 out of 10 stroke patients have some type of paralysis, which can require months or years of rehabilitation.
